Bethanechol for urinary retention & neurogenic bladder

Bethanechol is a parasympathomimetic drug that activates the parasympathetic nervous system. It activates the muscarinic receptors without affecting the nicotinic receptors. It is used to treat the following conditions:

Treatment of urinary retention as a result of urinary bladder atony secondary to a neurogenic cause.
Treatment of functional urinary retention following delivery or post-operatively.

Bethanechol Dose in Adults

Dose in the treatment of Urinary retention in patients with a neurogenic bladder:

5 - 10 mg orally.
The dose may be repeated hourly until response or a maximum dose of 50 mg is reached.
The usual dose is 10 - 50 mg three or four times a day.

Bethanechol Dose in Childrens

Dose in the treatment of non-obstructive Urinary retention:

Children and Adolescents:
- 0.3 - 0.6 mg/kg/day orally in 3 or 4 divided doses to a maximum dose of 10 mg/dose.
- The usual dose is 10 - 50 mg thrice or four times a day.

Pregnancy Risk Factor C

Pregnant women have not been tested for the drug.

Use of Bethanechol during breastfeeding

It is unknown if the drug can be absorbed into breastmilk.
Manufacturers recommend that you stop taking bethanechol and to discontinue breastfeeding during treatment.

Bethanechol Dose in Renal Disease:

Adjustment in the dose has not been recommended by the manufaturer in patients with renal disease.

Bethanechol Dose in Liver Disease:

Adjustment in the dose has not been recommended by the manufaturer in patients with liver disease.

Side Effects of Bethanechol Frequency not defined.

Cardiovascular:
- Flushing
- Hypotension
- Tachycardia
Central Nervous System:
- Colic
- Headache
- Malaise
- Seizure
Dermatologic:
- Diaphoresis
Gastrointestinal:
- Abdominal Cramps
- Borborygmi
- Diarrhea
- Eructation
- Nausea
- Salivation
- Vomiting
Genitourinary:
- Urinary Urgency
Ophthalmic:
- Lacrimation
- Miosis
Respiratory:
- Asthma
- Bronchoconstriction

Contraindication to Bethanechol include:

Allergy reactions to bethanechol and any component of the formulation
Hyperthyroidism
Peptic ulcer disease
Epilepsy
Asthma
Hypotension or Bradycardia
Vasomotor instability
Coronary artery disease
Parkinsonism
Occlusion of the Gastrointestinal and Genitourinary tracts by mechanical means
After urinary bladder surgery, Gastrointestinal Resection and Anastomosis
Bladder neck obstruction
Spastic Gastrointestinal Disorders
Acute inflammation of the Gastrointestinal tract
Peritonitis
Marked vagotonia.

Warnings and Precautions

Reflux infection:
- Patients with bacteriuria should be cautious as there are potential complications such as reflux infections.

Monitoring Parameters:

Monitor heart rate, Blood pressure, and ECG especially in cardiac patients.

How to administer Bethanechol?

It is administered one hour before meals or two hours after meals to avoid nausea and vomiting.

Mechanism of action of Bethanechol:

Bethanechol, a parasympathomimetic medication that stimulates parasympathetic nervous systems, is known as Bethanechol.
It causes the contraction of bladder muscles, which aids in emptying the bladder.
It stimulates gastric motility, which results in gastric emptying.

TheStart of actionIt takes approximately 30 minutes to complete thepeak effectIt can be seen in 60-90 minutes. It has been aDuration of the actionA dose of greater than 6 hours can be extended for up to one hour.

International Brands of Bethanechol: